CMS Formulary

Displaying 117401-117410 of 1611142 results.
ID: 117401
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 897044
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117402
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 758032
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 117403
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 117404
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650282
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117405
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 207836
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117406
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 796918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117407
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 117408
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 117409
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 117410
Formulary ID: 00021045
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0